开颅-2012.pptVIP

Dissection of cranium Step 1 Remove the calcaria Step 2 Dissect the dura matter Step 3 Remove the tentorum of cerebellum Step 4 Dissect the anterior 4 cranial ns. and internal carotid artery Step 5 Dissect the posterior 8 cranial ns. and vertebral a. Step 6 Remove the brain Step 7 Dissect the blood vessel of brain Step 8 Dissect the external featuers of the brain Step 9 Dissect the internal structures of the brain Step 10 Dissect the base of skull Step 1 Remove the calcaria Strip the scalp on the calcaria Mark the sawing line passing just above the superciliary arch and the external occipital protuberance Saw the skull Step 2 Dissect the dura matter Identify the middle meningeal artery Identify the superior sagittal sinus and arachnoid granulations Sagittal incisions on each sides of the superior sagitial sinus Transverse incision Cut the cerebral falx from anterior attachment(crista galli) Step 3 Dissect the anterior 4 cranial ns. and internal carotid artery Lift the frontal lobe and identify the olfactory bulbs Identify the optic n., optic chiasma, and internal carotid a. on both sides. Cut them on the base of the skull Further elevating the brain, identify and cut the infundibulum stalk of hypophysis behind the optic chiasma. Identify and cut the oculomotor n. on both sides Try to find the trachlear n. and tentorum of cerebellum behind the oculomotor n. Step 4 Remove the tentorum of cerebellum Raise the temporal and occipital lobes, observe the tentorum and tentorial incisure，and trachlear n. winding the middle brain Cut the attachment of tentorum to the petrous part of temporal bone and to the occipital bone Identify the glossopharyngeal, vagus and accessory nevers passing through the jugular foramen. Pull the brain to observe the hypoglassal n. and vertebral artery. at the foramen magnum Step 6 Remove the brain Insert the knife into the foramen magnum as deep as possible to cut the medulla oblongate/spinal cord and vertebral artery Step